| Summary: | Problem statement: Sexual and reproductive decision-making has emerged as an
important health indicator as husbands dominate in family reproductive health
issues and continue to be the greatest source of sexually transmitted infections
including HIV to their wives. While there is evidence of male dominance in sexual
and reproductive health decision, the role of socio-demographic factors on women's
control over their sexuality is not well understood. Using the theory of gender and
power, it was conceptualized that socio-cultural and socio-economic factors
influence women's control over their sexuality.
Objectives: The aim of this study was to investigate the extent to which women in
marital and cohabiting unions have control over their sexuality and implications on
reproductive health.
Method: To achieve this purpose sexual and reproductive health decision-making
survey of 568 respondents and 33 in-depth interviews was conducted among
married and cohabiting women in Mahikeng, South Africa in 2012. Data were
collected on respondents' socio-demographic characteristics and reproductive
health matters under which the relationship exits. Quantitative data were analyzed
using descriptive and logistic regression analyses. Qualitative information was
analyzed manually using thematic content analysis approach.
Result: The data reveals that unemployed women and those in traditional union
were less likely to agree that women can demand or reject sex from their husbands.
Rural women and those in arranged marriages showed lack of autonomy in
decisions on when to have sex and family size. Gap in knowledge of condom
efficiency and the usage seems to stem from lack of spousal communication.
Qualitative data revealed that sexual control are intertwined with cultural, religious
belief and perception that husbands have sexual right over their wives. Fear of
accusation and violence impaired the ability of women to suggest condom use to
their partners.
Conclusion: It may be concluded that limited control women had over their
sexuality (sexual and reproductive health decision-making) stemmed from poor
economic status, cultural gender norm and patriarchal dominance. These may have
negative implications on women's sexual and reproductive health.
Recommendation: Sexual and reproductive health decision-making in marital or
cohabiting relationships cut across secular, cultural and religious domain.
Government strategy to improve married women's control over sexuality need
partnerships of their husbands, traditional and religious leaders which should focus
on empowering women with income earning skills and bridging sexual
communication gap between couples. === Thesis (PhD (Population Studies) North-West University, Mafikeng Campus, 2014
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